COMMUNICATION ANDCOMMUNICATION AND
HEALTH BEHAVIORHEALTH BEHAVIOR
Dr. AmAny r. Abo-El-SEouDDr. AmAny r. Abo-El-SEouD
ProfESSor of CommunityProfESSor of Community
ZAgAZig univErSity.EgyPtZAgAZig univErSity.EgyPt
Communication:Communication: It is a requirement forIt is a requirement for
life in any society.life in any society. It is the process inIt is the process in
which feelings or ideas are expressed aswhich feelings or ideas are expressed as
messages: sent, received andmessages: sent, received and
The process of communication is dynamic,The process of communication is dynamic,
continuous, irreversible and transactional.continuous, irreversible and transactional.
Health educationHealth education : To raise awareness: To raise awareness
of people to prevent disease and toof people to prevent disease and to
improve knowledge, attitude and practiceimprove knowledge, attitude and practice
of individuals for healthy living.of individuals for healthy living.
Knowledge:Knowledge: confident understanding ofconfident understanding of
a subject with the ability to use it for aa subject with the ability to use it for a
specific purpose.specific purpose. المعرفةالمعرفة
Attitude:Attitude: positive, negative or neutralpositive, negative or neutral
view of a person, behavior or event.view of a person, behavior or event. موقفموقف
Belief:Belief: a subjective mental interpretationa subjective mental interpretation
derived from perception, reasoning orderived from perception, reasoning or
BehaviorBehavior: actions or reaction of a person: actions or reaction of a person
in relation to certain circumstances.in relation to certain circumstances. تصرفتصرف
Human communication is the process ofHuman communication is the process of
creating meaning between two or morecreating meaning between two or more
It is to transfer Ideas - Information - NormsIt is to transfer Ideas - Information - Norms
نماذجنماذج- Values - Attitudes through message- Values - Attitudes through message
to another party so that it can beto another party so that it can be
understood and acted upon.understood and acted upon.
Why do we communicateWhy do we communicate??
The importance of communication:The importance of communication:
To make people understand us and toTo make people understand us and to
understand others.understand others.
To make us accepted.To make us accepted.
To undertake something.To undertake something.
To strengthen the human relationshipsTo strengthen the human relationships
and social links.and social links.
To spread the human spirit of friendshipTo spread the human spirit of friendship
and cooperation.and cooperation.
Benefits in the medical fieldBenefits in the medical field
To improve patient complianceTo improve patient compliance
To improve patient satisfactionTo improve patient satisfaction
To improve health outcomes for patientsTo improve health outcomes for patients
To improve the accuracy and efficiency ofTo improve the accuracy and efficiency of
the consultation and hence is morethe consultation and hence is more
rewarding for the doctorrewarding for the doctor
Elements of communication
The Sender Who Sends the message: doctor, nurse,
parents, actor, teacher
The Message What Ideas, Information, Feelings,
Emotions. Can be at personal
hygiene, nutrition guide, safe
motherhood, risk factors etc
The Channel How Means of message transmission.
Face-face, group discussion, radio,
newspaper, conference, T.V,internet.
The Receptor To whom The person to whom we talk or the
one who receives the message.
Illiterate or highly educated, culture,
habits, traditions, language.
The Feedback With What
The information or the reaction
given to the receptor
Let us think
• You perform a health education program
in x village for family planning to increase
the users of pills. 2 weeks after the
message there was no increase in pill
What can hinderWhat can hinder
1-1- At the source or sender levelAt the source or sender level
Does not know or convinced with the subject.Does not know or convinced with the subject.
Cannot communicate the message.Cannot communicate the message.
Does not formulate clearly the objectives or theDoes not formulate clearly the objectives or the
Does not choose the suitable language of the receptor.Does not choose the suitable language of the receptor.
Does not change the tone.Does not change the tone.
The communicator must :The communicator must :
CLEAR=CLEAR= C: Clarify L: Listen E: Encourage A: AppreciateC: Clarify L: Listen E: Encourage A: Appreciate
R: ReassureR: Reassure
Do notDo not give orders. Do not attack. Do not be aggressivegive orders. Do not attack. Do not be aggressive
or ridiculousor ridiculous..
2-2- At the message levelAt the message level
Difficult words.Difficult words.
Is not of interest to the receiver.Is not of interest to the receiver.
Is not related to the stated objectives.Is not related to the stated objectives.
Unclear, confusing.Unclear, confusing.
3-3- At the channel levelAt the channel level
Not adapted to the message transmission.Not adapted to the message transmission.
Not accessible to the receptor.Not accessible to the receptor.
4-4- At the receptor levelAt the receptor level
Indifferent to the message.Indifferent to the message.
Could not decode (understand) the message.Could not decode (understand) the message.
Cannot receive the message.Cannot receive the message.
Poor listening conditions.Poor listening conditions.
5-5- At the feedback levelAt the feedback level
Feedback not well prepared.Feedback not well prepared.
Limited time.Limited time.
Selection of those who respond.Selection of those who respond.
Question poorly formulated.Question poorly formulated.
Forms (channels) ofForms (channels) of
Verbal:Verbal: By saying or writing words e.g.By saying or writing words e.g.
talk, discussion, conferencestalk, discussion, conferences,, oror
PresentationPresentation,, books, newspapersbooks, newspapers..
Intentional (signs and movements).Intentional (signs and movements).
Unconscious (Feelings) as way of clientUnconscious (Feelings) as way of client’’ss
walking, sitting, hand movements, facialwalking, sitting, hand movements, facial
expression, vocal characteristics (pitch,expression, vocal characteristics (pitch,
volume, rate).volume, rate).
Communication skills used inCommunication skills used in
the medical fieldthe medical field::
(1)(1)Skills of history takingSkills of history taking
(2)(2) Skills of CounselingSkills of Counseling
(3)(3)Skills of health educationSkills of health education
HEALTH EDUCATIONHEALTH EDUCATION
Aims at changing behavior of individuals towards healthy behavior.Aims at changing behavior of individuals towards healthy behavior.
It gives new information (unknown before) or change old wrongIt gives new information (unknown before) or change old wrong
Health education covers all the areas of community medicine, inHealth education covers all the areas of community medicine, in
health promotion (to give information to people how to be healthy) inhealth promotion (to give information to people how to be healthy) in
prevention of health hazards (give information about vaccination,prevention of health hazards (give information about vaccination,
smoking hazards) in control of disease (to take treatment accordingsmoking hazards) in control of disease (to take treatment according
to doctor advice) and in rehabilitation (to use the remaining healthto doctor advice) and in rehabilitation (to use the remaining health
Health education is concerned with physical, mental and socialHealth education is concerned with physical, mental and social
It is life long processIt is life long process
It can be directed to individual, family or communityIt can be directed to individual, family or community
Stages of behavioralStages of behavioral
Health belief modelHealth belief model ::
Awareness of the problem: to perceiveAwareness of the problem: to perceive
that there is a problem (to be aware of thethat there is a problem (to be aware of the
bad effect of obesity on health)bad effect of obesity on health)
Interest: to show an interest in the problemInterest: to show an interest in the problem
(he becomes interested in that subject and(he becomes interested in that subject and
he considers that he may be victim of thathe considers that he may be victim of that
complication/ disease).complication/ disease).
Knowledge: need to know more to decideKnowledge: need to know more to decide
to change and adopt an innovation .(toto change and adopt an innovation .(to
know more about obesity hazards).know more about obesity hazards).
Attitude: to decide to take action (he formsAttitude: to decide to take action (he forms
positive opinion about the bad outcome ofpositive opinion about the bad outcome of
obese persons).obese persons).
Legitimization: is that subject in line withLegitimization: is that subject in line with
legal, cultural, financial and sociallegal, cultural, financial and social
acceptance? If yes it is easily to practice .acceptance? If yes it is easily to practice .
(are friends know that obesity is bad? Is it(are friends know that obesity is bad? Is it
costly? Can I do it? What are the barrierscostly? Can I do it? What are the barriers
to change?)to change?)
Practice (action): try it to see its feasibilityPractice (action): try it to see its feasibility
and effectiveness.( I try to decrease fattyand effectiveness.( I try to decrease fatty
diets to see its effect on my health).diets to see its effect on my health).
Sustainability : to keep the change for life.Sustainability : to keep the change for life.
(keep eating healthy diet, with low fat(keep eating healthy diet, with low fat
Let us thinkLet us think
Apply the health belief model onApply the health belief model on
prevention of smokingprevention of smoking
Health belief modelHealth belief model
Feasibility of practicingFeasibility of practicing
Q :Q : When can we intervene by a healthWhen can we intervene by a health
education program in this model?education program in this model?
Health belief modelHealth belief model
To know disease
Behavior at illnessBehavior at illness
Do nothing &
e to ttt
to ttt and
Factors that affectFactors that affect
health/illness behaviorhealth/illness behavior
Age, sex, level of education, culture, religion, past experienceAge, sex, level of education, culture, religion, past experience
Recognition of symptoms, signs.Recognition of symptoms, signs.
Seriousness of symptoms/signsSeriousness of symptoms/signs
If these symptoms affect his ordinary lifeIf these symptoms affect his ordinary life
Persistence and frequency of symptomsPersistence and frequency of symptoms
Personal tolerance to symptomsPersonal tolerance to symptoms
Level of knowledge, cultural opinion about these symptomsLevel of knowledge, cultural opinion about these symptoms
Fear of illness to be fatal.Fear of illness to be fatal.
Stigma : community opinion towards patients of that illnessStigma : community opinion towards patients of that illness
Availability of medical servicesAvailability of medical services
Trusted services and health providersTrusted services and health providers
Planning for health educationPlanning for health education
"who says what and when to whom by"who says what and when to whom by
which channel"which channel"
therefore we should consider the following:therefore we should consider the following:
the message, sender, recipient, method,the message, sender, recipient, method,
barriers for changebarriers for change
Evaluation of H.E. programEvaluation of H.E. program
* Pre and post testing: for the same group or* Pre and post testing: for the same group or
for 2 groupsfor 2 groups
Every thing should be evaluated (theEvery thing should be evaluated (the
educator, message, method and theeducator, message, method and the
persons who are educated)persons who are educated)
* Increased number of good behaviors* Increased number of good behaviors
* Change in the morbidity & mortality rates* Change in the morbidity & mortality rates
How to design A questionnaireHow to design A questionnaire
Brief introduction, aim and gentle askingBrief introduction, aim and gentle asking
for co-operationfor co-operation
Simple language, direct questionsSimple language, direct questions
Not ask for 2 things in the same q.Not ask for 2 things in the same q.
Don’t use negative negative q.Don’t use negative negative q.
Short answers, closed q.Short answers, closed q.
Not too long questionnaireNot too long questionnaire
It must be reliable, validIt must be reliable, valid
2 types of questions:2 types of questions:
Qualitative (Likert’s scale) for attitude orQualitative (Likert’s scale) for attitude or
Quantitative: giving % or numberQuantitative: giving % or number
Multiple choices are easierMultiple choices are easier
Let us thinkLet us think
Design a questionnaire for assessing SEDesign a questionnaire for assessing SE
standard of living?standard of living?
Design a questionnaire for knowingDesign a questionnaire for knowing
feedback of students on Communityfeedback of students on Community
Design a questionnaire for pre test forDesign a questionnaire for pre test for
health education program for hepatitis C?health education program for hepatitis C?
My Best WishesMy Best Wishes
thank youthank you